Six months ago, on 13 March 2013, NHS Change Day, a social movement to demonstrate how small changes can have a big impact, came of age. NHS staff pledged a change in their practice which would improve patient experience and/or clinical outcomes by spreading and adopting best practice and championing innovation. An ambitious target of 65,000 pledges was set with a view to demonstrating that collective action was possible and beneficial.

In total, over 189,000 individual and organisational pledges were made. The Change Day team has subsequently been invited to the Francis implementation team's regional events to discuss how organisations can engage with staff effectively. It is the only UK entry to have been shortlisted for Harvard Business Review's "leaders everywhere challenge". The next step is to maintain this enthusiasm so that Change Day has a sustained impact on patient care. Change Day 2014 is already in evolution, and there is now global interest. But can we say we really made a difference?

The effects of pledges happened at individual, organisational and national levels. My own pledge – to test a variety of medications given to children with the aim of understanding some of the challenges facing parents – certainly touched a nerve. In total 123 people joined the pledge on the day which was videoed with television doctor Dr Ranj Singh and GP and Change Day leader Dr Stuart Sutton. What has changed as a result of this pledge? My own personal practice, certainly. One of the medications, not uncommonly prescribed, was surprisingly distasteful. I, along with others, discussed how to improve its taste with our pharmacies. It's a small but tangible behaviour change which will, hopefully, impact on patients.

A junior doctor in Torbay, Dr Kyle Stewart, arranged for clinical commissioning group staff to shadow a junior doctor for the day. Potential issues with IT resources, paging systems and a duplication of paperwork, all common problems for junior doctors throughout the country, were highlighted directly to commissioning staff. In turn it was noted the work ethic and communication of the doctors with patients was particularly strong.

Professor Sir Bruce Keogh will be shadowing junior doctors as part of his Change Day pledge this year. This further strengthens bonds with junior doctors who played an important role in the recent Keogh review of 14 underperforming hospital trusts.

At Birmingham children's hospital, Elle Milner, patient experience and participation support officer, was part of a great initiative leading to Feedback Wednesday where different departments get feedback from patients. This Change Day initiative is changing practice and creating a culture that isn't based on target-based, haphazard feedback but that responds to patients' needs.

The Network, an online community connecting 2,686 medical students, doctors and other healthcare professionals that aims to improve the quality of care in the UK, launched their second casebook – a collection of quality improvement projects conceived and delivered by its members. Many produced impressive outcomes, including tangible patient benefits and cost savings, with minimal budgets. The top three projects had an opportunity to present in front of an audience of medical leaders convened by Sir Bruce Keogh and one project contributed to Great Ormond Street's recent patient safety award.

Healthcare is an environment where 'change' can be an overused and a moral sapping word. While there is much work to be done on demonstrating direct patient benefit, through the examples above, Change Day has demonstrated the passion for improvement is alive and that change is possible.